Jeffery Matthew Balogh, DPT
Individual provider Active NPI Physical Therapist · Trinity, FL
NPI 1578078093 · NPPES record last updated Dec 6, 2017
Key facts
- NPI
- 1578078093
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT33139 (FL)
- Practice address
- 2165 Little Rd
Trinity, FL 34655-4410 - Phone
- (727) 372-6637
- NPI assigned
- Dec 6, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Florida Joint Care Institute LLP
Practice addresses (Care Compare)
2165 Little Rd
Trinity, FL 34655-4410
Phone (727) 372-6637
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180713002453 | FL | Practitioner - Physical Therapist in Private Practice | 3870840366 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT33139 | FL | MD | Physical Therapist |
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Joint Care Institute LLP | Current |
Accepting new patients |
Locations
2165 Little Rd
Trinity, FL 34655
Phone (727) 372-6637
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT33139 | FL | Yes |
Addresses
Primary practice location
2165 Little Rd
Trinity, FL 34655-4410
Mailing address
2165 Little Rd
Trinity, FL 34655-4410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT33139 | Other | FL | STATE LICENSE |
Other providers in Trinity, FL
- Corie L Bailey
- Timothy S Bailey
- Janet Sue Bailie
- Emmaly Heather Baker
- Kristina Ball
- Nastassia G Baltodano
- Taylor Barchowski
- Reut Bardach
- Jennifer L Bargerhuff
- Barkdoll Massage Therapy LLC
All providers in Trinity, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.